Structural heart disease: One valve does not fit all.

Title

Structural heart disease: One valve does not fit all.

Creator

German KS; Kalra A

Publisher

Current opinion in supportive and palliative care

Date

2019
2019-03

Description

PURPOSE OF REVIEW: Highlight the difficulties patients, physicians, and the global economy face in relation to treatment of structural heart diseases. It is easy to be carried away by the excitement of medical advancement; however, it is difficult to demonstrate restraint. Transcatheter aortic valve replacement (TAVR) is a modern marvel that can help many patients when utilized appropriately. This article highlights the work that has been done to facilitate decision-making in this challenging patient population. RECENT FINDINGS: Patient selection is of paramount importance as TAVR remains a costly intervention. Currently, our gold standards for preprocedural patient evaluation are inadequate. Apropos, several objective tools are being developed to help clinicians evaluate frailty. Giving patients a more accurate postprocedure prognosis allows them to make informed decisions on whether this intervention is appropriate for their respective goals. SUMMARY: In order for us to fully embrace shared decision-making and cost-effectiveness, we must continue to work on our prognostic tools and have honest conversations with patients and their families to formulate individualized treatment plans. This becomes even more important when factors like economic impact of intervention are considered. In an era where cost-effective care has garnered more attention than ever before, we must do our best to make sure our interventions are in line with patient goals and offer the maximum amount of benefit, given the current cost of TAVR.

Subject

Humans; Prognosis; Age Factors; Risk Factors; Severity of Illness Index; Risk Assessment; Cost-Benefit Analysis; Patient Care Planning; Patient Participation; Decision Making Shared; Frailty/epidemiology; Heart Valve Diseases/surgery; Transcatheter Aortic Valve Replacement/economics/methods/mortality

Identifier

PMID: 30507630

Rights

© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Pages

14-17

Issue

1

Volume

13

ISSN

1751-4266 1751-4258

NEOMED College

NEOMED College of Medicine

NEOMED Department

Department of Internal Medicine

Update Year & Number

June2020SubmittedList

Affiliated Hospital

Cleveland Clinic Akron General Hospital

Citation

German KS; Kalra A, “Structural heart disease: One valve does not fit all.,” NEOMED Bibliography Database, accessed January 21, 2021, https://neomed.omeka.net/items/show/11188.

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